title: Staff immunisation: policy and practice in child care.
abstract: OBJECTIVE
  The aims of this study were to determine the level of knowledge among child-care centre directors regarding the National Health and Medical Research Council (NHMRC) recommendations for the immunisation of child-care workers, the extent to which this knowledge was translated into practice and any organisational barriers to the development and implementation of staff immunisation policy.
  
  
  METHODS
  A cross-sectional survey, conducted in August 2006, in which a postal questionnaire was sent to a random sample of 784 NSW child-care centres. Centre directors were asked to complete the questionnaire on immunisation knowledge, policy and practice for the centre. A multivariate logistic-regression model was used to identify factors independently associated with centres with an immunisation policy for staff and centres that offered to pay all or part of the cost of vaccination of staff.
  
  
  RESULTS
  Directors from 437 centres participated in the study for a response rate of 56%. Of these, 49% were aware of the NHMRC recommendations, and 57% had a staff immunisation policy in place. In the logistic regression model, centres with a written immunisation policy for staff were more likely to be aware of the NHMRC guidelines and offer long day care services. Centres that offered to pay all or part of the cost of immunisation for staff were more likely to be aware of the NHMRC guidelines, offer other child-care services and not operate for profit. Barriers to staff immunisation were related to the implementation of policy and included cost, time and access to information.
  
  
  CONCLUSIONS
  The level of awareness of specific staff immunisation recommendations was relatively low. The transition of knowledge to policy was encouraging, although implementation of policies requires further commitment.
authors.affiliation: NSW Public Health Officer Training Program, NSW Department of Health, North Sydney, New South Wales, Australia. paula.spokes@doh.health.nsw.gov.au
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Spokes
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Ferson
authors.forename: Kelly-Anne
authors.initials: KA
authors.lastname: Ressler
mesh_terms: D002648:Child; D002654:Child Care; D002656:Child Day Care Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000379:methods* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D007114:Immunization / Q000523:psychology / Q000706:statistics & numerical data; D016015:Logistic Models; D009517:New South Wales; D009784:Occupational Diseases / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data*